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� <br />� • <br />PERMIT <br />• <br />APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 - 425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />ADDRESS: r I. 1 � << PROPERTYTAX# PERMIT# _ <br />� r� � <br />c <br />� ^ �� � i..�J,:Tr l ��.�,9if1�� �--��t;� '%�L % �j — ��. ��. �: C�[� �4�1 � �.V ''��� <br />1L for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />ER ,i�`[� � � �'-G 1 ��� � f �� ' � tX .l �,i'�I' � _ Phone/E-mail <br />��' �c.x �7 CA <br />% � �(��_ N�.\� •- <br />BUILDING PERMIT APPLICATION <br />City/State/Zip <br />� � � Un, L & I Lic. # ' � $" '- <br />I; �(In 1 n:� l C r7. � Phone/Email �/;j �-'%� yZ( ,,��C <br />ne/E-mai� �NG`LI/� �-td�" ��� l�Ll�� 7i��7 -`� �j _ 5�C I <br />NTRACT PRICE OF WORK � ��7 � � �� . ��` <br />Existing Use of Building ��;C l� �� ti/�,� �lQ,��.�i�-�i HEAT SOURCE: <br />Proposed Use of Building c;-+ ,'iP f� IIn.rL'e � V�[�J �i-�. Gas �� Electric_ Other <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family JC Commercial <br />Type of project: 7� New _ Addition _ Remodel _ Repair _ T.I. _ Sign _Sprinkler _Demolition_Change of Use <br />Description of Work (additional space provided on the back) : r I <br />�Vl /�ll �'7 � �✓�.�."�l��l��..���� �Z7� ,�,I�.�lil��� �lNV'�.S \ � ) ���c��y�e �YW1�� �'l�L�t�.'� �L�'L� Yr��� �rL�, � <br />/ <br />�)�-y C',1', �r �' � � ` <br />Have you startedZivorking without a permit? YES K NO <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: �New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />A/C — air handlin units <br />Forced air svstems <br />Water heater <br />Gas rar <br />Clothes <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Woodstove <br />Ducting <br />Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />PLUMBING PERMI'T APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Toilet <br />Bathtub <br />Shower <br />Kitchen sink & c <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/b� <br />Backflow orevei <br />Drinkina Fountain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing <br />this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel <br />the provision of any other state or local law regulating construction or the perFormance of construction. That I am authorized by the owner of this property <br />to perform the work for which appl ation is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC i� <br />�) _ � <br />. y "i Z� IZ <br />Owner/Authorized Agent Signa ure Date (Revised 2/2011) <br />